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General NPI Number Information
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NPI Number | 1710634621
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Entity Type | Individual
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Provider Name | LUCY LYNE PHARMACIST
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Gender | Female
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Dates
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Enumeration Date | 03/10/2022
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Last Update Date | 03/10/2022
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Provider Practice Location Address
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Address Line | 2 COOPERSHAWK LN
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City | CHADDS FORD
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State | PA
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Zip | 19317-9714
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Country | US
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Telephone | 610-742-8662
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Fax |
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Provider Business Mailing Address
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Address Line | 602 WHITE CLAY CENTER DR
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City | NEWARK
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State | DE
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Zip | 19711-5455
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Country | US
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Telephone | 610-742-8662
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP032732L
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License Number State | PA
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